TY - JOUR
T1 - Time From Distress Call to Percutaneous Coronary Intervention and Outcomes in Myocardial Infarction
AU - Mills, Elisabeth Helen Anna
AU - Møller, Amalie Lykkemark
AU - Engstrøm, Thomas
AU - Folke, Fredrik
AU - Pedersen, Frants
AU - Køber, Lars
AU - Gnesin, Filip
AU - Zylyftari, Nertila
AU - Blomberg, Stig Nikolaj Fasmer
AU - Kragholm, Kristian
AU - Gislason, Gunnar
AU - Jensen, Britta
AU - Lippert, Freddy
AU - Kragelund, Charlotte
AU - Christensen, Helle Collatz
AU - Andersen, Mikkel Porsborg
AU - Torp-Pedersen, Christian
N1 - © 2024 The Authors.
PY - 2024/7
Y1 - 2024/7
N2 - BACKGROUND: Early percutaneous coronary intervention (PCI) is recommended for ST-segment elevation myocardial infarction (STEMI) treatment. Delays in time-to-PCI, kept within guideline recommendations, have seldom been investigated.OBJECTIVES: The purpose of this study was to investigate the consequences of delay, due to system factors or hospital distance, for the time between last patient distress call and PCI.METHODS: Registry-based cohort study including times of first call to medical services, admission and PCI for patients admitted with STEMI in Copenhagen, Denmark (2014-2018). The main combined outcome included death, recurrent myocardial infarction, or heart failure estimated at 30 days and 1 year from event. Outcomes according to time from call to PCI (system delay) and door-to-balloon time were standardized to the STEMI population using multivariate logistic regression.RESULTS: In total, 1,822 STEMI patients (73.5% male, median age 63.3 years [Q1-Q3: 54.6-72.9 years]) called the emergency services ≤72 hours before PCI (1,735, ≤12 hours). The combined endpoint of 1-year cumulative incidence was 13.9% (166/1,196) for patients treated within 120 minutes of the call and 21.2% (89/420) for patients treated later. Standardized 30-day outcomes were 7.33% (95% CI: 5.41%-9.63%) for patients treated <60 minutes, and 11.1% (95% CI: 8.39%-14.2%) for patients treated >120 minutes.CONCLUSIONS: The risk of recurrent myocardial infarction, death, and heart failure following PCI treatment of STEMI increases rapidly when delay exceeds 1 hour. This indicates a particular advantage of minimizing time from first contact to PCI.
AB - BACKGROUND: Early percutaneous coronary intervention (PCI) is recommended for ST-segment elevation myocardial infarction (STEMI) treatment. Delays in time-to-PCI, kept within guideline recommendations, have seldom been investigated.OBJECTIVES: The purpose of this study was to investigate the consequences of delay, due to system factors or hospital distance, for the time between last patient distress call and PCI.METHODS: Registry-based cohort study including times of first call to medical services, admission and PCI for patients admitted with STEMI in Copenhagen, Denmark (2014-2018). The main combined outcome included death, recurrent myocardial infarction, or heart failure estimated at 30 days and 1 year from event. Outcomes according to time from call to PCI (system delay) and door-to-balloon time were standardized to the STEMI population using multivariate logistic regression.RESULTS: In total, 1,822 STEMI patients (73.5% male, median age 63.3 years [Q1-Q3: 54.6-72.9 years]) called the emergency services ≤72 hours before PCI (1,735, ≤12 hours). The combined endpoint of 1-year cumulative incidence was 13.9% (166/1,196) for patients treated within 120 minutes of the call and 21.2% (89/420) for patients treated later. Standardized 30-day outcomes were 7.33% (95% CI: 5.41%-9.63%) for patients treated <60 minutes, and 11.1% (95% CI: 8.39%-14.2%) for patients treated >120 minutes.CONCLUSIONS: The risk of recurrent myocardial infarction, death, and heart failure following PCI treatment of STEMI increases rapidly when delay exceeds 1 hour. This indicates a particular advantage of minimizing time from first contact to PCI.
UR - http://www.scopus.com/inward/record.url?scp=85193857622&partnerID=8YFLogxK
U2 - 10.1016/j.jacadv.2024.101005
DO - 10.1016/j.jacadv.2024.101005
M3 - Journal article
C2 - 39129988
SN - 2772-963X
VL - 3
SP - 101005
JO - JACC: Advances
JF - JACC: Advances
IS - 7
M1 - 101005
ER -